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+--- Thread: Sleepy Head loses Notes (/Thread-Sleepy-Head-loses-Notes)
RE: Sleepy Head loses Notes - ROBBY98 - 12-15-2018
Connected with Mark.
Installed Mark's latest test version update.
Thanks!
RE: Sleepy Head loses Notes - Sleeprider - 12-15-2018
The new version loads a lot faster and takes care of a lot of issues. It's not in widespread use, but is a far superior program that incorporates support for many machines not supported by 1.0.0 Beta 2.
RE: Sleepy Head loses Notes - ROBBY98 - 12-15-2018
You are correct.
It was diagnosed complex with central and obstructive.
Home study and over nite study both
While the results show low, I'm still not sleeping right.
The machine provider was surprised that it was not prescribed ASV in the beginning.
I'm going to try to get a sleep doc to change it to ASV.
Will try lowering the pressure in the mean time slowly.
RE: Sleepy Head loses Notes - Sleeprider - 12-15-2018
(12-15-2018, 10:05 AM)ROBBY98 Wrote: You are correct.
It was diagnosed complex with central and obstructive.
Home study and over nite study both
While the results show low, I'm still not sleeping right.
The machine provider was surprised that it was not prescribed ASV in the beginning.
I'm going to try to get a sleep doc to change it to ASV.
Will try lowering the pressure in the mean time slowly.
The reason you are not on ASV is that you are "effectively treated" with CPAP. You would need a higher AHI to move to the next level under insurance. While we are pretty good here at optimizing results, we can also show you the path to ASV. Just change to Autoset mode at 8-15 cm and turn on EPR full time at 3. I'm pretty sure that would get your AHI over 20. It's a choice whether you pursue ASV, and it involves some short-term discomfort. You seem to be aware of the issues, and eventually CPAP may not adequately reduce CA and H events, but for now it's working at fixed pressure without EPR. You are not sleeping right, but insurance uses the AHI metric to decide if you can be authorized to use bilevel (HCPCS Code E0470) which you will more quickly fail before being allowed a bilevel with backup rate (E0471) like ASV.
This is what you're up against https://www.cgsmedicare.com/jc/mr/pdf/mr_checklist_rad_e0471.pdf
https://www.resmed.com/us/dam/documents/articles/1010293_RAD_Guidelines.pdf
Simply put, your CPAP therapy must degrade to greater than 5 AHI with mostly central events.
RE: Sleepy Head loses Notes - ROBBY98 - 12-15-2018
I get it.
Let me digest this.
Let's see where the AHI numbers are in a week.
They were well over 5.
Thanks so much.
RE: Sleepy Head loses Notes - ROBBY98 - 12-16-2018
Based on your experience-
Lower the pressure how much?
What increments?
Examples:
A gradually decrease in pressure to say 8?
RE: Sleepy Head loses Notes - Sleeprider - 12-16-2018
Remember, optimizing may compromise your ability to qualify for a device that treats central events and periodic breathing. Lower pressure generally reduces central apnea while increasing flow limitation. Reverse titration is simply the process of reducing pressure in 1-cm increments until obstructive apnea increases. At that point, adding pressure back in 0.2-0.4 increments should identify the optimum therapy pressure.
RE: Sleepy Head loses Notes - ROBBY98 - 12-16-2018
Based on your experience-
Lower the pressure how much?
What increments?
Examples:
A gradually decrease in pressure to say 8?
RE: Sleepy Head loses Notes - ROBBY98 - 12-16-2018
How much detailed data can the provider see over cellular?
I can try my backup Airsense 10 for test.
RE: Sleepy Head loses Notes - ROBBY98 - 12-16-2018
[attachment=9412]
Shown here, EPR is actually on.
Based on what you saw..would it be better to have it off?